Advances in Anterior Cruciate Ligament (ACL) Reconstruction Surgery
Your knee joint is a major weight bearing joint that helps you walk, run, and perform most activities of daily living. It is supported by strong ligaments that keep it stable.
The anterior cruciate ligament, or the ACL, is the most important stabilizing ligament of the knee. The ACL prevents the knee from sliding forward or rotating towards the front and sides. An injury to the ACL will cause instability, particularly in rotational, cutting or pivoting movements. People may feel their leg is giving out, shifting or buckling.
Most ACL injuries are “non-contact” injuries, meaning that the mechanism of injury was not caused by a collision. The foot twists, balance is lost, and the knee torques in a direction and position that is not compatible with the ligament’s normal loading potential. This results in a failure of the ACL. You may have felt a pop, click, pain, and or tenderness, followed by swelling and painful range of motion. ACL tears are common in skiing, basketball, soccer, and football. Females have an approximate 40% greater number of ACL injuries in most sports compared to males.
Choosing the Graft
There are commonly three graft choices when it comes to ACL reconstruction surgery: patellar tendon autograft (patient’s own tissue), hamstring autograft (patient’s own tissue) or allograft (cadaveric tissue). For patients under the age of 40, autograft is recommended as it has been shown in multiple well-conducted studies to have lower failure rates compared to allograft/cadaveric tissue. Allograft is suitable for patients over the age of 40-45 years and less active.
Failures of ACL reconstructions from incorrect placement of the graft led to extensive research and improvement in surgical technique. The focus now is on anatomic reconstruction – Dr. Patel is specially trained in this form of surgery. The reconstruction tunnel is drilled at the anatomic attachment site of the ACL on the tibia and a closed socket tunnel is drilled at the ACL attachment site on the femur. The graft is pulled into the joint and fixed in place with screws or buttons. Dr. Patel performs this via a minimally invasive arthroscopic approach, allowing for less pain post-operatively for the patient.
In most cases, arthroscopic ACL reconstruction with Dr. Patel can be performed within an hour and is an outpatient or same day surgery.
Dr. Ronak Patel is a Board-Certified Orthopedic Surgeon offering a full range of care for all problems of the knee and shoulder with a special interest in complex knee disorders including ACL reconstruction. Book your appointment with Dr. Patel today.